Provider Demographics
NPI:1306801956
Name:INDURTI, SREEKANTH VENKATA (MD)
Entity type:Individual
Prefix:DR
First Name:SREEKANTH
Middle Name:VENKATA
Last Name:INDURTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2452
Mailing Address - Country:US
Mailing Address - Phone:614-706-2786
Mailing Address - Fax:614-505-8343
Practice Address - Street 1:5151 MONROE ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3462
Practice Address - Country:US
Practice Address - Phone:419-885-0200
Practice Address - Fax:419-885-0203
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0816412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2655309Medicaid
OH2655309Medicaid
OHH70579Medicare UPIN